Healthcare Provider Details

I. General information

NPI: 1538552203
Provider Name (Legal Business Name): LUKAS STREICH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2015
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1348 NE CUSHING DR STE 210
BEND OR
97701-3876
US

IV. Provider business mailing address

1348 NE CUSHING DR
BEND OR
97701-3876
US

V. Phone/Fax

Practice location:
  • Phone: 541-382-7696
  • Fax:
Mailing address:
  • Phone: 541-382-7696
  • Fax: 541-389-5723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number125.072348
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD210940
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: